career structure for genetic counsellors · 3 career structure a) trainee genetic counsellor it is...

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A constituent group of the British Society of Human Genetics

CAREER STRUCTURE FOR

GENETIC

COUNSELLORS

MARCH 2012

Association of Genetic Nurses and Counsellors

Administrative Office Clinical Genetics Unit (BSHG) Birmingham Women’s Hospital Edgbaston, Birmingham B15 2TG Tel: 0121 627 2634 Fax: 0121 623 6971 Email: [email protected] Website: www.agnc.org.uk

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PREFACE

In the UK, the Genetic Counselling profession is composed of individuals from varying professional and academic backgrounds, usually employed by the NHS, and sometimes by research bodies, universities and charities. Since the Career Structure paper was published in 2005 there have been significant developments across the Genetic Counselling profession. Notably the registration process is well established, with continual developments from the Genetic Counsellor Registration Board (GCRB). The GCRB set and monitor standards for entry into the profession and maintain a voluntary professional register of practitioners, mentors and assessors. As of 2011, 161 genetic counsellors have become GCRB registered. The Genetic Counsellor Statutory Regulation Steering Group (GCSRSG) was set up to oversee the application for statutory regulation. In 2009 the GCSRSG application was accepted by the HPC and was awaiting approval by parliamentary ratification. However in the February 2011 Command Paper ‘enabling excellence, autonomy and accountability for health care workers, social workers and social care workers’, the government proposed to no longer support statutory regulation as a means to regulate new health professions1.

The current government are recommending new means to offer professional regulation through the principle of right touch regulation2. As of October 2011 the AGNC in collaboration with the GCRB are attempting to influence the future shape of a quality assured register, currently under the remit of the Professional Standards Authority (PSA) currently known as the Council for Health Care Regulatory Excellence (CHRE) .Work is ongoing to determine whether this is a feasible and appropriate solution for the genetic counselling profession.

The AGNC committee and the GCRB recognise the importance of moving towards regulation to maintain quality and standards in the profession for the ultimate protection of patients. To support this work, it is important to define the specific roles and responsibilities at different levels within the profession and the corresponding career structure. Following the implementation and cascade of ‘Agenda for Change’ across the NHS it is recognised that Genetic Counsellors (GC’s) from a nursing and MSc background are now matched to the same pay and progression scales. The success of the AGNC knowledge skills framework (KSF) outlines for posts has brought some uniformity to the career structure of the Genetic Counselling profession3. This document has been developed both as a resource for GC’s, genetic counselling managers and service leads to support the development of GC roles and appropriate GC career structure locally; and to assist the ongoing work around formal regulation of the GC profession in the UK.

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Career structure

A) TRAINEE GENETIC COUNSELLOR

It is anticipated that an individual will be in a training post for 2 years and will then be eligible to submit an intention to apply to register as a Genetic Counsellor. By definition, an individual should remain at this level for a fixed term only. It would be inappropriate for an individual to remain in the trainee genetic counsellor post permanently. However, a permanent post could be adjusted to reflect an initial equivalent training period, e.g. through annexe U. After the trainee has completed at least two years in a genetic counselling post under the supervision and mentorship of a registered genetic counsellor who is based at an approved genetic centre they will eligible to apply for UK GCRB genetic counsellor registration.

Previous Training / Qualifications/Experience. Post-holder should meet entry level criteria for GCRB registration (set A or B)

Set A

Attainment of a GCRB approved/accredited Master of Science (MSc) degree in Genetic Counselling

Set B

Attainment of a First or Masters Degree.

Plus:

Attainment of a professional qualification as a registered nurse or midwife and maintenance of current professional registration.

plus Previous experience as a senior registered practitioner having developed and demonstrated proficiency as an autonomous professional in a health care setting.

plus Completion of training in counselling skills of at least 90 guided learning hours4 (from 2012 at least 30 hours of the counselling training must be delivered via an academically accredited course and the applicant must show evidence of having passed a formal assessment/examination as part of that course).

plus Completion of an academically accredited course in the science of human genetics of no less than 30 guided learning hours. The applicant must show evidence of having passed a formal assessment/examination as part of that course.

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CRITERIA RELATED TO GENETIC COUNSELLING EXPERIENCE Applicants may submit their Intention to register form when they have completed at least two years in a genetic counselling post under the supervision and mentorship of a Registered Genetic Counsellor who is based in an approved Genetic Centre5 For at least two years full time (or equivalent part time), the main focus of an applicant’s work must have been clinical (rather than in other areas such as research or education) and should have included a breadth of experience involving both general and cancer cases.

ADDITIONAL NOTES AND GUIDANCE For applicants that have taken a Masters level degree in Genetic Counselling, the two year clinical period of genetic counselling experience begins when formal written notification from the university of successful completion of the degree is received. Specialist genetic counsellors (e.g. in cancer) can use the general registration process but must demonstrate non-specialist genetic counselling skills. Applicants who are uncertain as to whether their post or Genetic Centre fulfils GCRB training standards and all applicants based outside the UK or Republic of Ireland should contact the Board for guidance.

At this level all Trainees will:

In accordance with the GCRB registration process5.

• Be in a clinical post under the supervision of a recognised genetics centre.

• During the 2 years of training, experience the full spectrum of genetic conditions (paediatric, prenatal, adult and cancer genetics) and counselling scenarios (e.g. carrier, predictive, prenatal testing).This may include placements in other accredited genetic training centres.

• Receive regular clinical and counselling supervision.

• Undergo appraisal with a named educational supervisor on a 6 monthly basis.

• Develop an awareness of the functional structure of general management and relationships in the NHS.

Roles and Responsibilities

Supervised management of a case-load of patients/clients requiring genetic counselling. It is anticipated that the nature of case management supervision will change as competencies are achieved. Work may include:

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• Pre-clinic work-up for a variety of genetic conditions.

• Independent genetic counselling.

• Post-clinic follow-up as required.

• Perform prenatal and predictive counselling under supervision. Note: contact with patients may involve home visits, clinic appointments, telephone counselling and written communication.

• Liaising with other health-care professionals and agencies as appropriate.

• Blood-taking.

• Small audit and evaluation projects under the supervision of a Genetic Counsellor Genetic Counsellor/Principal Genetic Counsellor /Consultant Genetic Counsellor or Clinical Geneticist.

• Limited contribution to teaching, e.g. in small groups.

Professional Contribution

• Involvement in departmental activities.

• Membership of appropriate professional bodies and attendance at meetings (when work may be presented), etc.

Limits of Role

Trainees will not undertake the following independently, but may do so supervised as part of their training and development:

• Acting as the lead genetic counsellor in predictive genetic testing. Working as lead genetic counsellor where patient is known or found to have significant psychological/psychiatric/social or legal issues.

• Primary responsibility in the management of a genetic register.

• Representing the Clinical Genetics department on an external board/ body, unless representation from a ‘Trainee’ is specifically requested. However, Trainees should be encouraged to accompany more senior Genetic Counsellors to meetings of such boards/bodies, to be present as observers.

Trainees will use the title Trainee Genetic Counsellor when communicating with patients.

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B) GENETIC COUNSELLOR At this level, there has been a transition from higher training to independent work. The individual will have built on a training foundation to establish a sound reputation as a genetic counsellor. The individual will be identified as a clinical specialist within the employing authority. The individual will normally have direct clinical involvement in, and an extensive knowledge of, genetic counselling.

Previous Training/Qualifications/Experience

The individual will have achieved the following:

• Achieved the core competencies of GCRB Registration5

• Gained GCRB Registration in Genetic Counselling or be ready to apply imminently.

Many Genetic Counsellors registered overseas will be eligible to register in the UK after a period of acclimatisation depending on experience in their home country. For full details please see the UK Registration of Overseas Genetic Counsellor guidelines (www.gcrb.org.uk)6.


This individual will:

• Have responsibility for a range of clinical tasks as outlined in the ‘Roles and Responsibilities’ of the Trainee Genetic Counsellor. In addition, this individual’s work may involve:

o Taking a lead role in predictive genetic testing. o Responsibility for more challenging cases than at Trainee level. o Autonomous work. o Responsibility for managing a defined caseload, area or patient group. o Responsibility for a genetic register.

• Have limited responsibility for the supervision of:

o Trainees. o Medical students/undergraduate students. o New staff. o GCRB registration (Registered GC with 5 years experience who have

undertaken current GCRB Assessor and Sign-Off Mentoring training may undertake these roles).

• Participate in the teaching of genetics to:

o Other health care professionals, including hospital doctors and GPs.

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o Medical students/other students. o Lay groups.

• Contribute to service planning and development and formulation of departmental policies and protocols.

• Contribute to audit and evaluation.

• Contribute towards research.

• Develop good management skills across a limited range of responsibilities. These could include the ability to direct the work of students and Trainee Genetic Counsellors.

• Have a broad understanding of general management and relationships within the NHS.

• Demonstrate ongoing professional development, for example undertaking further education, attending relevant professional conferences/meetings, completing appropriate training courses.

• Maintain Genetic Counsellor Registration (See GCRB Renewal Guidelines7).


• Involvement in departmental and multidisciplinary activities within the local environment.

• Involvement in appropriate professional bodies through attendance and presentation at meetings, etc.

Limits of Role

The individual will not:

o Line-manage staff. o Have any budgetary responsibilities. o Be a named supervisor for Trainees. o Be the sole supervisor of medical students undertaking special study

modules (SSM).

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C) Principal Genetic Counsellor

This post is seen as being an expert clinical grade where the post-holder will have substantial experience and training beyond that of a Genetic Counsellor.

The individual will take independent responsibility for a range of complex work demanding skilled performance, with the ability to identify the need to confer with colleagues.

Previous Training/Qualifications/Experience

This individual will

• Typically have 5 years experience at Genetic Counsellor.

• Be a GCRB Registration Genetic Counsellor.

• Have a greater emphasis on clinical experience than on formal qualifications.

• Have experience in service planning and development, and of the formulation of policies and protocols.

• Have experience of audit, evaluation and research.

• Show evidence of having developed management skills.

• Have completed additional relevant specialist training.

• Show evidence of taking responsibility for organising appropriate teaching and/or research.

• Show evidence of professional development.


An individual at this level may work in one or make a significant contribution to a combination of the following areas:

I Clinical

II Research III Education

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I) Clinical

Continuing responsibility for a clinical case-load using advanced genetic counselling skills acquired as a Genetic Counsellor, either working in a Regional Genetics Centre or in an out-reach position attached to a Regional Genetics Centre. The individual will be working at this high level doing either of the following:

• Generic genetic counselling, covering a broad range of genetic conditions and counselling scenarios. The individual will act as a significant resource to the wider health care system and be recognised as an expert within the profession.

• Taking a lead role in providing expert genetic counselling in a defined area of specialisation

In addition they:

• Continue to take a key role in teaching responsibilities.

• Take a key role in the planning, development and provision of cross-disciplinary specialist services, policies and protocols.

• Take a lead role in audit and evaluation, and in the supervision of projects undertaken by Genetic Counsellors.

• Contribute to the management of a changing and/or developing service.


• Would be expected to act as a GCRB Sign-Off Mentor or Assessor for genetic counsellors during their registration process following appropriate training.

II) Research

Undertaking innovative research that will make a positive contribution to Genetic Counselling theory and evidence based practice. This should lead to:-

• Peer-reviewed published papers, including the individual as first author.

• Presentation of research at scientific conferences.

Contributing to the development of national standards and/or interventions in genetic counselling.

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Genetic counsellors working solely or predominantly in a research capacity would also typically be expected to:-

• Hold a relevant research qualification.

• Be affiliated to an academic institution.

• Make a continued and significant contribution through novel research and development to the evidence base for genetic counselling and genetic healthcare.

III) Education

• Undertaking the development and management of courses from modules to an MSc course in genetic counselling.

• Devising, organising and implementing educational and training courses for genetic counsellors and other health care professionals.

• Make a significant contribution to public education in genetics.

Management

The Principal Genetic Counsellor role will also typically incorporate leadership and managerial responsibilities in conjunction with at least one other of the above areas:

• Team leader of a group of genetic counsellors or genetic healthcare researchers within a speciality, which could include responsibility for budgets or grants (if appropriate), physical resources, selection and appointment of new staff and contribution to staff appraisal.

• Demonstrating ability to work in a wider management role, including management of personnel.

• Developing efficient and effective business processes and procedures to promote improved patient service.


Active participation through:

• Membership of topic groups and specialist interest groups; attendance and presentation at meetings and conferences.

• Leadership at a local and national level. This may include holding office on a relevant committee.

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Limits of Role

• Unlike a Consultant Genetic Counsellor, a Principal Genetic Counsellor will not be expected to fulfil all areas of education, research and genetic counsellor service leadership responsibility simultaneously.

• This grade will not be expected to take full managerial responsibility for a department’s genetic counsellors.

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Expert level Genetic Counsellor roles Expert level Genetic Counsellor roles impact beyond the local area of work. Within the NHS these posts are banded across a range of bands 8b to 8d. They would be required to fulfil a broad range of areas of service leadership education, research and genetic counsellor service leadership responsibility simultaneously. NHS employed roles with a large component of research and education leadership may be matched against Consultant Genetic Counsellor profiles, NHS roles with a large component of managing staff may be matched against clinical professional manager national profiles.

Di) Consultant Genetic Counsellor

The individual will act as a significant resource for expert professional advice to the wider health care system and be recognised as an expert within their profession. This individual will have a lead role locally and nationally in a field of expertise. This role may be broad (generic) or within a specialised area of genetic counselling practice, as defined by the individual’s expertise or the requirements of a particular department. The individual will undertake clinical work, education and training responsibilities, research and management. At least 50% of their time will be accounted for by their clinical work. The proportion of time spent on other aspects of the role will depend upon the individual’s expertise and the requirements of a particular department.

Training/Qualifications/Experience

This individual will

• Be a GCRB Registered genetic counsellor

• Typically have 5 years experience as a Principal Genetic Counsellor.

• The quality and outcome of experience should reflect the level of clinical and scientific insight and leadership.

• Be expected to have gained the highest level of expert knowledge in their area of expertise. They will be educated to Masters Level or beyond. It would not be unusual for such a candidate to hold higher postgraduate education e.g. relevant PhD, Clinical Doctorate, or Masters in leadership or management administration.

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• Have a proven track record of influential research/audit in the field of genetic counselling, as demonstrated by publications/conference presentations. Be able to demonstrate active involvement with innovative practice developments and demonstrate evidence of significant achievements gained.


• Act as lead genetic counsellor within area(s) of expertise.

• Work in partnership with the Trust (or equivalent) in order to develop a strategic approach for the provision of service. Responsible for proposing, developing and implementing policy for genetic counselling service and establishing how policies should be interpreted.

• In line with Trust (or equivalent), develop, lead and implement standards for clinical audit and evaluate clinical effectiveness.

• Work in collaboration with academic institutions to lead on education, research and practice development, and produce further publications.

• Take a key role in developing national protocols.

• Lead on developments and innovations within the field.

• Offer specialist consultancy, both within the Trust (or equivalent) and outside.


Contribute to the following management activities:

• Appraisal/review of staff within their team.

• Identifying and facilitating educational and training needs of staff.

• Will often provide support and mentoring for Trainee, Genetic Counsellor and Principal Genetic Counsellors.

• Will be expected to act as a GCRB Sign-Off Mentor or Assessor for genetic counsellors during the registration process following appropriate training.


• Maintain national and international profile of the genetic counselling profession.

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• Will be active nationally in specialist subject area (or areas), and will participate in national meetings and hold membership of organising bodies or professional committees. The individual may hold an office in such a committee within the profession or within a multidisciplinary group, and/or be active internationally.

Limits of Role

• Will refer as appropriate to other genetic counsellors/clinical geneticists/laboratory scientists, etc who have other areas of expertise.

• This grade will not be expected to take managerial responsibility for the department’s genetic counsellors.

Dii) Lead Genetic Counsellor/ Genetic Counsellor Manager A Lead Genetic Counsellor / Genetic Counsellor Manager will primarily have management and training responsibilities, but at least 25% of her/his time will be accounted for by their clinical caseload. The proportion of time spent on other aspects of the role will depend upon the individual’s expertise or the requirements of a particular department.

This role will demand effective leadership and could involve managing groups extending beyond Genetic Counsellor personnel. It could provide management opportunities and experience appropriate to the pursuance of Departmental or Directorate level Management posts.

Training/Qualifications/Experience

This individual will:

• Be a GCRB Registered genetic counsellor.

• Typically have 5 years experience as a Principal Genetic Counsellor.

• The quality and outcome of experience should reflect the level of clinical and scientific insight, management skills and insight and leadership.

• Be educated to Masters Level or beyond in a relevant subject.

• Have relevant management experience and training, which may include a recognised post graduate management qualification

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• Be able to demonstrate active involvement with innovative practice developments and demonstrate evidence of significant achievements gained.


• Provide line management and professional leadership for the team of genetic counsellors at various stages of training and experience, ensuring staff are supported in their work.

• Define the standard of care to be provided by Genetic Counsellors and delegate duties and workloads whilst being responsible for maintaining standards and competencies at various levels.

• Responsible for disciplinary procedures whenever necessary.

• Recruitment of genetic counsellors (and other members of staff as agreed locally).

• Appraisal and staff development programmes of all grades of genetic counsellors (and where appropriate other members of staff as agreed locally).

• Identify and facilitate educational and training needs of staff, including managing training budget for genetic counsellors.

• Providing support and mentoring for Trainee, Genetic Counsellor and Principal Genetic Counsellors.

• Work in partnership with the Trust and/or other relevant bodies to develop a strategic approach for the provision of service, including business planning and contract negotiation.

• In line with Trust (or equivalent), develop, lead and implement standards for clinical audit and evaluate clinical effectiveness including clinical risk management.

• Systematically introduce, manage, evaluate and consolidate service changes.

• Take a key role in developing management protocols.


• Would be expected to act as a GCRB Sign-Off Mentor or Assessor for genetic counsellors during their registration process following appropriate training if required.

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Professional Contribution Contribute to national and international profile of the genetic counselling profession.

Will be active nationally and will participate in national meetings and hold membership of organising bodies or professional committees. The individual may hold an office in such a committee within the profession or within a multidisciplinary group, and/or be active internationally.

Limits of role

• Refer/defer to other genetic counsellors/clinical geneticists/laboratory scientists, etc., who have specific areas of expertise, as appropriate.

• Would not be expected to maintain the same daily clinic workload or level of clinical expertise as Consultant Genetic Counsellor post.

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References

1. Enabling excellence, autonomy and accountability for health care workers, social

workers and social care workers, Department of Health, February 2011. Accessible at http://www.dh.gov.uk

2. Right touch regulation, Council for Healthcare Regulatory Excellence, August 2010. Accessible at http://www.chre.org.uk/.

3. Knowledge Skills and Frameworks outlines for Genetic counsellor posts described in the AGNC Career Structure. http://www.agnc.org.uk/About%20us/KSF/Knowledgeandskillsframework.htm

4. Guided learning hours (GLHs) are defined as “all times when a member of staff is present to give specific guidance towards the learning aim being studied on a programme. This includes lectures, tutorials and supervised study in; for example, open learning centres and learning workshops. It also includes time spent by staff assessing a learner’s achievements...” (Learning and Skills Council, Funding Guidance for Further Education, 2004).

5. GCRB registration process (see www.gcrb.org.uk). 6. GCRB Overseas Guidelines (see www.gcrb.org.uk) 7. GCRB Renewal of Registration (see www.gcrb.org.uk)

Glossary

• GCRB Assessor: An expert genetic counsellor who assesses portfolios submitted nationally for the Certification in Genetic Counselling to Master’s level. They will have completed up-to-date training through GCRB Mentor’s and Assessors courses.

• GCRB Sign-Off Mentor: An expert genetic counsellor who mentors a genetic counsellor for the purpose of preparing to submit a portfolio of evidence for Certification in Genetic Counselling. They will have completed up-to-date training through GCRB Sign-Off Mentor’s and Assessors courses.

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Career Pathway for Genetic Counsellors

Level A

Level B

Level C

Level D

Trainee GeneticCounsellor from

nursing orequivalent

background

Trainee GeneticCounsellor fromMSc in Genetic

Counsellingbackground

Genetic Counsellor

Di) ConsultantGenetic

Counsellor

Dii) GeneticCounsellorManager

Principal Genetic Counsellor

Level C posts may be specialist in clinical, research or educationor may combine these specialities.

The post may also include aspects of management.

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Job profiles for Agendas for Change were published on the DOH website on 01/07/2005 NATIONAL PROFILES FOR GENETIC COUNSELLORS CONTENTS

Profile Title AfC Banding

Page

Genetic Counsellor Trainee 6 2 Genetic Counsellor 7 3 Genetic Counsellor Principal 8a* 4 Genetic Counsellor Consultant 8b-d 5

*Generic profile provisions apply - see note below Generic Profiles The following generic profile note extracted from the Second Edition of the Job Evaluation Handbook explains the position in cases where the minimum score falls below the relevant grade boundary: (See para 5.2 Section 7) The band for jobs covered by this generic profile is band e.g. 4. The minimum total profile score falls below the band 4 grade boundary. This is the result of using a single generic profile to cover a number of jobs of equivalent by not necessarily similar factor demand. It is not anticipated that any job will be assessed at the minimum level of every possible factor range. If this were the case it indicates that the job should instead be matched against a band 3 profile. If this is not successful, the job must be locally evaluated.

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Profile Label: Genetic Counsellor Trainee Job Statement: 1. Undertakes genetic counselling under the guidance of a more senior counsellor and maintains relevant records

2. Attends genetic counselling clinics and carries out home visits 3. Working towards registration with professional body

Factor Relevant Job Information JE Level

1. Communication and Relationship Skills

Provide and receive highly complex, sensitive or contentious information; barriers to understanding; provide and receive complex, sensitive information hostile, antagonistic or highly emotive atmosphere Elicits highly sensitive information relating to e.g. prenatal carrier testing, inherited genetic testing where there is resistance to the notion of genetic inheritance and a need to reassure and empathise with the patient/client; communicates sensitive information where patients/clients may be hostile

5(a)(c)

2. Knowledge, Training & Experience

Specialist knowledge across range of procedures underpinned by theory Professional knowledge acquired through relevant degree plus clinical experience and counselling training or equivalent to postgraduate diploma level

6

3. Analytical & Judgmental Skills

Range of facts or situations requiring analysts Initial assessment of patient/client's family tree and history where risk factors are analysed and judgements made on testing and reporting of results

3

4. Planning & Organisational Skills

Plan and organise straightforward activities, some ongoing Manages ongoing caseload of patients/clients

2

5. Physical Skills Highly developed physical skills, accuracy important; manipulation of fine tools, materials Hand eye co-ordination, accuracy required when carrying out e.g. venepuncture, microscope work

3 (b)

6. Responsibility for Patient/Client Care

Develop programmes of care; provide specialist clinical technical services Arranges appropriate screening and testing programme, counsels accordingly; interprets diagnostic test results

5(a)(b)

7. Responsibility for Policy/Service Development

Follows policies in own role, may be required to comment Follows national and organisational policies applicable to role, may comment on departmental procedures

1

8. Responsibility for Financial & Physical Resources

Personal duty of care in relation to equipment, resources Careful use of genetic counselling facilities

1

9. Responsibility for Human Resources

Demonstrate own duties Demonstrates own duties to others

1

10. Responsibility for Information Resources

Record personally generated information Maintains patient/client records

1

11. Responsibility for Research & Development

Undertake surveys and audits, as necessary to own work/regularly undertake R&D activities Completes regular activity audits and caseload statistics, participates in local, regional or national research projects

1-2(a)

12. Freedom to Act Clearly defined occupational policies, work is managed rather than supervised Works with patients/clients independently within codes of conduct and policies, work is assessed during clinical supervision

3

13. Physical Effort Combination of sitting, standing, walking Walks between clinics, sits during assessments

1

14. Mental Effort Frequent intense concentration In-depth proactive mental attention during patient/client risk assessment and counselling

5

15. Emotional Effort Frequent distressing or emotional circumstances, occasional/frequent highly distressing Counselling the terminally ill or bereaved where there is a need for genetic testing/dealing with challenging family situations e.g. paternity identification, morbidity/mortality risk assessment

3(a)(b)- 4(b)

16. Working Conditions

Occasional/frequent unpleasant/occasional/frequent highly unpleasant conditions Body odours, exposure to blood during venepuncture

2(a) 3(b) 4(b)

JE Score/Band JE Score 398 – 423 Band 6

Page 2 of 5 Published 01-07-05

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Profile Label: Genetic Counsellor Job Statement: 1. Assesses and provides genetic counselling to patients/clients

2. Manages a caseload and maintains patient/client records 3. Provides support and guidance to students and less experienced counsellors

Factor Relevant Job Information JE Level 1. Communication and Relationship Skills

Provide and receive highly complex, sensitive or contentious information; barriers to understanding; provide and receive complex, sensitive information hostile, antagonistic or highly emotive atmosphere Elicits highly sensitive information relating to e.g. prenatal carrier testing, inherited genetic testing where there is resistance to the notion of genetic inheritance and a need to reassure and empathise with the patient/client; communicates sensitive information where patients/clients may be hostile

5(a)(c)


Specialist knowledge across range of procedures underpinned by theory Knowledge of genetic counselling procedures and techniques acquired through relevant degree plus clinical experience and counselling training plus further specialist training to master's level equivalent

7


Complex facts or situations requiring comparison of a range of options Initial assessment of patient/client's family tree and complex history where risk factors are analysed and judgements made on testing, reporting of results and referral to specialist

4


Plan and organise straightforward activities, some ongoing/complex activities requiring formulation, adjustment Manages ongoing caseload of patients/clients, co-ordinates multi-disciplinary case conferences

2-3


3 (b)


Develop programmes of care; provide highly specialist clinical technical services Arranges appropriate specialist screening and testing programme, counsels accordingly; interprets complex diagnostic test results

6(a)(b)


Follows policies in own role, may be required to comment/implement policies and propose changes to practices, procedures for own area Follows national and organisational policies/implements policies related to provision of genetic counselling service, proposes changes to service delivery and working practices

1-2



1


Professional, clinical supervision Supports and mentors trainees, students undertaking placements

2(b)


Records personally generated information Maintains patient/client records

1


Undertake surveys and audits, as necessary to own work/regularly undertake R&D activities Completes regular activity audits and caseload statistics, participates in local, regional, national research projects

1-2(a)

12. Freedom to Act Clearly defined occupational policies, work is managed rather than supervised/broad occupational policies Works within professional guidelines/works autonomously, lead practitioner, own caseload in the community

3-4


1


5

15. Emotional Effort Frequent distressing or emotional circumstances, occasional/frequent highly distressing Counselling the terminally ill or bereaved where there is a need for genetic testing/dealing with challenging family situations e.g. paternity identification, morbidity or mortality risk assessment

3(a)(b)- 4(b)



2(a) 3(b) 4(b)

JE Score/Band JE Score 469 – 524 Band 7

Page 3 of 5

Published 01-07-05

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Profile Label: Genetic Counsellor Principal Job Statement: 1. Assesses and provides specialist genetic counselling to patients/clients

2. Manages a specialist caseload and maintains patient/client records 3. Maintains a knowledge of the scientific medical and psychological aspects of clinical

genetics and provides support and guidance to students, genetic counsellors and other health professions

4. Provides specialist training, may lead a specialist team Factor Relevant Job Information JE Level 1. Communication and Relationship Skills

Provide and receive highly complex, sensitive or contentious information; barriers to understanding; present complex, sensitive or contentious information to large groups; provide and receive complex, sensitive information hostile, antagonistic or highly emotive atmosphere Elicits highly sensitive information relating to e.g. prenatal carrier testing, inherited genetic testing where there is resistance to the notion of genetic inheritance and a need to reassure and empathise with the patient/client; gives presentations at conferences; communicates sensitive information where patients/clients may be hostile

5(a)(b)(c)


Highly developed specialist knowledge, underpinned by theory and experience Knowledge of genetic counselling procedures and techniques acquired through relevant degree plus clinical experience and counselling training plus further specialist training to master's level equivalent

7


Complex/highly complex facts or situations requiring analysis, interpretation, comparison of a range of options Initial assessment of patient/client's family tree and history where complicated risk factors are analysed, test results interpreted and judgements made/expert opinions may differ

4-5


Plan and organise complex activities or programmes, requiring formulation, adjustment Plans and organises multidisciplinary clinics and meetings, organises student work placements

3


3 (b)


Develop specialised programmes of care; provide highly specialist clinical technical services Arranges appropriate specialist screening and testing programme, interprets diagnostic test results and advises accordingly

6(a)(b)


Propose policy or service, impact beyond own area Develops policies in area of specialism which impact on other disciplines e.g. genetic testing in childhood

3



1


Day to day management, allocate, place and supervise staff or students, teach/deliver specialist training/teach, devise programmes as major job responsibility Undertakes placement programmes for students, provides specialist training in area of expertise

3(a)(b)(c) 4(c)



1


Regularly undertake R&D activities/major job requirement Participates in local, regional, national research projects

2(a) - 3

12. Freedom to Act Broad occupational policies Interprets policies in relation to own specialist caseload

4


1


5


3(a)(b)- 4(b)



2(a) 3(b) 4(b)

JE Score/Band JE Score 524* - 580 Band *8a

Page 4 of 5 Published 01-07-05

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Profile Label: Genetic Counsellor Consultant Job Statement: 1. Provides expert professional advice to patients/clients, colleagues and other health

professionals 2. Acts as lead genetic Counsellor in field of expertise 3. Collaborates with academic institutions to lead on education, research and practice

development 4. Provides specialist consultancy within organisation and externally

Factor Relevant Job Information JE Level 1. Communication and Relationship Skills

Provide and receive highly complex, sensitive or contentious information; barriers to understanding; present complex, sensitive or contentious information to large groups; provide and receive complex, sensitive information hostile, antagonistic or highly emotive atmosphere Elicits highly sensitive information relating to e.g. prenatal carrier testing, inherited genetic testing where there is resistance to the notion of genetic inheritance and a need to reassure and empathise with the patient/client; gives presentations at conferences; communicates sensitive information where patients/clients may be hostile

5(a)(b)(c)


Advanced theoretical and practical knowledge Professional knowledge acquired through degree, supplemented by specialist training to masters’ level, PhD or equivalent. Highest level of specialist knowledge in own area

8(a)


Highly complex facts or situations requiring analysis, interpretation, comparison of a range of options Initial assessment of patient/client's family tree and highly complex history where complicated risk factors are analysed, test results interpreted and judgements made in unique situations or where opinion differs

5


Plan and organise broad range of complex activities or programmes, formulates, adjusts plans or strategies Develops strategy, service planning

4


3 (b)


Develop specialised programmes of care; provide highly specialist clinical technical services Arranges appropriate specialist screening and testing programme, interprets diagnostic test results and advises accordingly

6(a)(b)


Responsible for policy implementation and development for a service Responsible for proposing, developing and implementing policy changes for genetic counselling service

4


Personal duty of care in relation to equipment, resources/authorised signatory, small payments Careful use of genetic counselling facilities/signatory for expenses

1-2(d)


Teach/deliver specialist training/teach, devise training and development programmes, major job responsibility Provides specialist training & education/develops education programmes

3(c)-4(b)



1


R&D activity as major job requirement/co-ordinate, implement R&D activity as job requirement Involved in research projects on an ongoing basis/supervises collection of data and management of research projects

3-4

12. Freedom to Act General policies, need to establish interpretation Responsible for establishing how policies should be interpreted

5


1

14. Mental Effort Occasional/frequent intense concentration In-depth proactive mental attention during patient/client risk assessment and counselling

4(b)-5


3(a)(b)- 4(b)


Occasional/frequent unpleasant/occasional highly unpleasant conditions Body odours, exposure to blood during venepuncture

2(a) 3(a)(b)

JE Score/Band JE Score 627 – 675 Band 8b-c-d

Page 5 of 5

Published 01-07-05

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Job Title: Job Statement:

Professional Manager (Clinical, Clinical Technical Service) 1. Manages staff, including recruitment, appraisal, CPD, performance 2. Responsible for policy & service development 3. Accountable for service delivery: liaises with other agencies as appropriate 4. Responsible for budget & physical resources

Factor Relevant Job Information JE level

1. Communication & Relationship Skills

Provide and receive highly complex, sensitive or contentious information; barriers to understanding; present complex, sensitive or contentious information to large groups/ significant barriers to acceptance; hostile, antagonistic or highly emotive atmosphere Communicates service-related information to senior managers, staff, external agencies: requires negotiating, persuasive, motivational, reassurance skills; gives formal presentations/ manage and reconcile conflicting views where there are significant barriers to acceptance or understanding

5-6


Advanced theoretical & practical knowledge Professional knowledge acquired through degree, supplemented by specialist training to doctorate or equivalent level, management qualification or equivalent, Experience

8(a)

3. Analytical & Judgemental Skills

Highly complex facts or situations requiring analysis, interpretation comparison of a range of options Skills for analysing service, client, organisational, staffing issues

5


Plan and organise broad range of complex activities; formulates, adjusts plans, strategies Operational planning of service, business planning

4

5. Physical Skills Physical skills obtained through practice; Developed physical skills; advanced keyboard use; Highly developed physical skills, accuracy important; manipulation of fine tools materials Driving, keyboard skills/ skills needed for professional practice, requiring accuracy and/or speed required for professional practice

2-3 (a)(b)


Accountable for direct delivery of clinical, clinical technical, social care service(s) Accountable to trust for delivery of service

7


Responsible for policy implementation & development for a service/ Responsible for policy implementation & development for a directorate or equivalent Responsible for proposing & implementing service/departmental policies/ responsible for policy implementation and service development for a directorate or equivalent

4-5


Budget holder for department/service; procurement of physical assets or supplies for department/service/ responsible for budget for several services Holds budget; procures capital equipment, supplies/ holds budgets for several Services

4 (a) (c)5(a)


Line manager for single function or department/ several/ multiple departments Manages staff of department/ directorate or equivalent including recruitment career development, performance, work evaluation

4-5(a)


Records personally generated information Updates patient/client, work records

1


Regularly undertakes R&D activity; R&D as major job requirement; coordinate, implement R&D activity as job requirement Undertakes research; carries out research as major job requirement/ co-ordinates and implements R & D programmes

2-4

12. Freedom to Act General policies, need to establish interpretation Operates independently, manages department, interprets organisational policies

5

13. Physical Effort Combination of sitting, standing, walking; Frequent light effort for short periods; occasional/ frequent moderate for several short periods Effort required for carrying out clinical/ technical duties

1/ 2(b); (d)/ 3 (c)

14. Mental Effort Frequent concentration, work pattern unpredictable Concentration for e.g. analysis, writing reports, meetings, patient/client assessment, interruptions to deal with service issues

3(a)

15. Emotional Effort Occasional distressing / highly distressing or emotional circumstances Deals with staff problems, patient complaints, conveys unwelcome news/ unexpected deaths

2-3(b)

16. Working Conditions Occasional/frequent unpleasant conditions Conditions relating to carrying out clinical/technical duties

2-3

JE Score/Band JE Score 641-748 Band 8c-9

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Originally produced by career structure and salaries working group in 2005:

Chris Barnes Jan Birch Tara Clancy Marion McAllister, Anne Roberts Fiona Robson Kate Sarson Gillian Scott

Document updated March 2012 Mark Longmuir, AGNC chair Carolyn Owen, AGNC Vice chair Laura Boyes, AGNC committee member And the AGNC Committee

career structure for genetic counsellors · 3 career structure a) trainee genetic counsellor it is...

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